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NMSU researcher helps develop online breast cancer risk calculator

Growing up, Charlotte Gard knew she came from a long line of women who developed breast cancer. The New Mexico State University assistant professor always expected her mother to develop it, like her grandmother before her, so she knew she wanted to contribute to research that would help fight the disease that kills more than 40,000 women in the U.S. every year.


Woman seated at computer
Charlotte Gard, an assistant professor of applied statistics in New Mexico State University’s College of Business is conducting statistical research on breast cancer risk and breast density assessment. (NMSU photo by Darren Phillips)

You won’t find her working with cells in a biology lab, though. Her weapon against cancer is statistical analysis – and she played a key role in the development of an online tool that allows women and their physicians to more accurately assess their risk and make informed decisions about preventative health care.

Gard is a biostatistician who teaches in the Department of Economics, Applied Statistics and International Business in NMSU’s College of Business. She also works as a consultant with the National Cancer Institute-funded Breast Cancer Surveillance Consortium. As a result of that work with a team of researchers from the University of California-San Francisco, UC-Davis, Group Health Research Institute and the Mayo Clinic, the consortium has rolled out an updated online breast cancer risk calculator, which can estimate five- and 10-year invasive breast cancer risk based on a woman’s age, race and ethnicity, family history, breast biopsy history and breast density.

“Our tool is unique in that it combines both breast density and biopsy results,” Gard explained. “It’s the only risk assessment tool that includes BI-RADS breast density, which is the breast density that’s used in clinical practice.” BI-RADS stands for the Breast Imaging Reporting and Data System of the American College of Radiology.

When a woman has a mammogram, Gard said, her radiologist will assign a breast density measure of “a,” “b,” “c” or “d,” where “a” indicates mostly fatty tissue and “d” indicates extremely dense tissue. Numerous studies that have shown that women who have dense breasts are at higher risk for developing breast cancer.

By including this breast density information along with benign biopsy results, the calculator helps paint a clearer picture of a woman’s risk compared to other women of her age, race and ethnicity.

Currently, 24 states require that women undergoing mammography who have breast density “c” or “d” be notified of their breast density. New Mexico is not among them, Gard said, but federal legislation to make that a nationwide requirement is under consideration. This means more women will be receiving information about breast density in their mammography reports and talking with their doctors about how density impacts their risk.

“We’re hoping that having this tool available will be helpful to physicians and women when these discussions start taking place,” Gard said.

New Mexico Department of Health spokesman David Morgan said any new tool that may help doctors and patients evaluate risk is a welcome addition.

“Every person should be armed with as much information as possible when they make decisions – with their doctors – about their health care,” Morgan said.

The breast cancer risk calculator is available at https://tools.bcsc-scc.org/BC5yearRisk. A paper on the new risk assessment model was recently published in the Journal of Clinical Oncology.

Gard is also conducting research on the misclassification of breast density by radiologists.

“I’m interested in understanding how radiologists differ from each other in their interpretation of density, and how this could impact breast density reporting to women,” she said. “There is a lot of variability from radiologist to radiologist, and you could create a false sense of security or you could alarm women unnecessarily when reporting based on a single density measurement.”

She’s exploring how characteristics like a radiologist’s experience level or training might impact the variability.

“If we can identify factors that can predict their variability, we could potentially intervene with some kind of training,” Gard said.

Both of these areas of research aim to help women obtain more accurate information about their risk and understand the potential implications of that risk, she said.

“I think it’s important that women can understand their risk of developing breast cancer, especially as women become more informed about their breast density,” Gard said. “The concern is that women are going to be informed of their breast density and they’re not going to know what to do with that information. So here’s something that we can give them that’s geared toward helping them better understand their risk and, with their physicians, determine what the best next steps are for them.”